The relation between questionnaire-measured self-reported emotional eating and disordered eating behaviors: A meta-analysis of nearly three decades of research

Extensive research exists on the association between self-reported emotional eating (EE) and disordered eating (DE) behaviors. Heterogeneity exists by type (e.g., unidimensional vs. multidimensional) and valence (e.g., negative vs. positive) of self-reported EE, and no previous meta-analyses have examined the association between self-reported EE and DE behaviors. A total of 67 studies (N = 26,289; 43 reporting relations in one model, and 24 reporting relations in more than one model) met inclusion criteria; ranges for age and publication date were 18.0-61.8 years old and 1995 to 2022. Five models quantified relations between DE behaviors and 1) broad negative EE, 2) EE in response to depression, 3) EE in response to anger and anxiety, 4) EE in response to boredom, and 5) EE in response to positive emotions. Using random-effects models, pooled Cohen's d effect sizes suggested small, positive relations between DE behaviors and self-reported broad negative EE (d = 0.40, p < 0.001), EE-depression (d = 0.41, p < 0.001), EE-anger/anxiety (d = 0.35, p < 0.001), and EE-boredom (d = 0.38, p < 0.001). A significant, but very small, positive relation was observed between DE behaviors and self-reported EE-positive (d = 0.08, p = 0.01). Subgroup analyses suggested a medium, positive relation between self-reported broad negative EE and binge eating (d = 0.53, p < 0.001) and a small, positive relation between self-reported broad negative EE and dietary restraint (d = 0.20, p < 0.001). Significant heterogeneity was identified across all models except for the EE-boredom and DE behaviors model. Higher BMI, but not age, clinical status, or type of DE behavior strengthened the positive relation between self-reported broad negative EE and DE behaviors. Findings support previous research suggesting that negative and positive EE are distinct constructs, with negatively valenced EE being more closely associated with DE behaviors, especially binge eating.

Adaptive and maladaptive emotion regulation skills are associated with food intake following a hunger-induced increase in negative emotions

Many individuals would like to lose weight and often attempt to do so by dieting. However, dieting attempts often backfire and contribute to the risk of weight gain and obesity. Food restriction inevitably leads to hunger and hunger, in turn, induces negative emotions. The inability to regulate such a hunger-induced increase in negative emotions in an adaptive way may be responsible for overeating. The current study aimed to gain a better understanding of this potential psychological mechanism underlying failed dieting attempts. Adaptive and maladaptive emotion regulation (ER) were assessed with an online questionnaire in women with a healthy weight. Subsequently, participants were assigned to the fasted condition (fasting for 14h, n = 49) or the satiated condition (eating between 2 h and 30 min before the lab session, n = 59) and attended a lab session in which they completed tasks while given the opportunity to eat chips and M&M's. We did not find an association between any ER variable and the likelihood to begin eating. Among those who began eating, higher scores on adaptive cognitive ER and on maladaptive behavioral ER were associated with lower caloric intake in fasted individuals. Higher scores on adaptive behavioral ER were associated with higher caloric intake in fasted individuals. Utilizing adaptive cognitive ER when experiencing a hunger-induced increase in negative emotions may help individuals manage their food intake and maintain a healthy weight.

A scoping review of emotion regulation and inhibition in emotional eating and binge-eating disorder: what about a continuum?

BACKGROUND

Emotional eating is defined as a nonpathological eating behavior, whereas binge-eating disorder (BED) is defined as a pathological eating behavior. While different, both share some striking similarities, such as deficits in emotion regulation and inhibition. Previous research has suggested the existence of an "eating continuum" that might reflect the increased severity of overeating behaviors, that is, from nonpathological overeating to BED. The main aims of this scoping review were to explore in the literature the idea of a continuum between emotional eating and BED and to observe whether deficits in emotion regulation and inhibition follow this continuum in terms of severity. The other aims were to hopefully clarify the ill-defined concept of overeating, to question the potential role of positive emotions and to identify potential knowledge gaps.

METHOD

A systematic scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Two databases (PubMed/Medline and PsycINFO) were examined in complete accordance with the beforehand sharply defined eligibility and exclusion criteria. The main criteria included adults (≥ 18) with emotional eating, BED or overeating and emotion regulation and inhibition as exposure criteria.

RESULTS

Thirty-two studies were included in this scoping review. If the results showed a link between emotional eating and BED, with the presence of inhibition and emotion regulation deficits in both eating behaviors, no mention of a continuum between emotional eating and BED was found.

CONCLUSION

In the absence of research directly comparing emotional eating and BED in the same studies and testing the potential increase in severity of emotion regulation and inhibition deficits along this continuum, there is currently no certainty that a continuum exists between emotional eating and BED. In the end, the idea of a continuum in terms of increased severity of overeating and in terms of emotion regulation and inhibition deficits between emotional eating and BED appears to be a gap in knowledge in the literature. This scoping review highlights the need for further research to identify knowledge gaps.

Lateral hypothalamic proenkephalin neurons drive threat-induced overeating associated with a negative emotional state

Psychological stressors, like the nearby presence of a predator, can be strong enough to induce physiological/hormonal alterations, leading to appetite changes. However, little is known about how threats can alter feeding-related hypothalamic circuit functions. Here, we found that proenkephalin (Penk)-expressing lateral hypothalamic (LHPenk) neurons of mice exposed to predator scent stimulus (PSS) show sensitized responses to high-fat diet (HFD) eating, whereas silencing of the same neurons normalizes PSS-induced HFD overconsumption associated with a negative emotional state. Downregulation of endogenous enkephalin peptides in the LH is crucial for inhibiting the neuronal and behavioral changes developed after PSS exposure. Furthermore, elevated corticosterone after PSS contributes to enhance the reactivity of glucocorticoid receptor (GR)-containing LHPenk neurons to HFD, whereas pharmacological inhibition of GR in the LH suppresses PSS-induced maladaptive behavioral responses. We have thus identified the LHPenk neurons as a critical component in the threat-induced neuronal adaptation that leads to emotional overconsumption.

Associations between early poverty exposure and adolescent well-being: The role of childhood negative emotionality

Using a longitudinal design (Wave 1 n = 164, Mage = 3.57 years, 54% female, predominantly White and French-speaking), the current study sought to answer two questions: 1) does poverty influence children's negative emotionality through heightened family-level, poverty-related stress? and 2) is negative emotionality, in turn, predictive of adolescent internalizing symptoms, externalizing behaviors, cognitive abilities, and physical health? Results confirmed an indirect pathway from family poverty to child emotionality through poverty-related stress. In addition, negative emotionality was associated with adolescent internalizing symptoms, attention difficulties, and physical health, but not externalizing symptoms, even when controlling for early poverty exposure.

Winter Holidays and Their Impact on Eating Behavior-A Systematic Review

(1) Background: There has been a growing interest in understanding the causes of obesity and developing effective prevention strategies. Lifestyle change programs are often considered the gold standard for weight reduction, and they can help individuals with obesity achieve an annual weight loss of around 8-10%. The aim of this review was to evaluate the effect of food during the winter holidays. This knowledge will serve as a valuable foundation for the development of targeted interventions and prevention programs. (2) Methods: We conducted a systematic search of the literature via one database (PubMed). The search was limited to studies published in English in the last 10 years, with adult participants, but without specifying limits regarding the study design. We excluded articles that addressed intermittent fasting diets or weight loss intervention methods during the holidays through various diets. (3) In separate sections, we analyzed the psychological causes of gaining weight during the winter holidays, behavioral patterns, prevention strategies and the nutritional composition of the different types of food served during the festive period. Results: Using the combination of the terms "holiday and obesity", "holiday and weight gain", "festive season and obesity", and "festive season and weight gain" we obtained 216 results involving the addressed topic. Thus, only ten articles remained after screening, with a total of 4627 participants. Most participants experienced weight fluctuations during the study period, particularly during holidays. One concerning observation was that most of the weight gained during these periods was maintained even after the end of the studies, especially in those with obesity. A supervised exercise program and a controlled diet at work over the Christmas period are effective strategies for avoiding weight gain and its deleterious effects in people with metabolic syndrome or weight problems. (4) In addition, attention must be focused on the psycho-social factors during the holidays because for some people it is a stressful period and can cause a much higher caloric consumption. The simplest method to approach during the holidays is to implement small tips and tricks during this period that will prevent individuals from gaining extra pounds. Conclusions: It is essential to acknowledge that obesity is a multifaceted condition that requires a comprehensive and multidisciplinary approach to address its underlying factors and provide ongoing assistance to individuals in their weight-management endeavors. Even the most effective short-term interventions are likely to produce continued positive outcomes with persistent intervention and support.

Key Nutrients for Optimal Blood Glucose Control and Mental Health in Individuals with Diabetes: A Review of the Evidence

Diabetes is associated with an increased risk of mental disorders, including depression, anxiety, and cognitive decline. Mental disorders can also contribute to the development of diabetes through various mechanisms including increased stress, poor self-care behaviors, and adverse effects on glucose metabolism. Consequently, individuals suffering from either of these conditions frequently experience comorbidity with the other. Nutrition plays an important role in both diabetes and mental health disorders including depression and anxiety. Deficiencies in specific nutrients such as omega-3 fatty acids, vitamin D, B vitamins, zinc, chromium, magnesium, and selenium have been implicated in the pathogenesis of both diabetes and mental disorders. While the impact of nutrition on the progression and control of diabetes and mental disorders is broadly acknowledged, there is a notable knowledge gap concerning the implications of distinct nutrients in preventing and mitigating symptoms of both conditions when they coexist. The aim of this study was to examine the role of nutrition in improving glucose homeostasis and promoting mental well-being among individuals with diabetes. Further, we evaluated the preventive or delaying effects of key nutrients on the simultaneous manifestation of these conditions when one of them is present. Our findings indicated that the use of personalized dietary interventions and targeted nutrient supplementation can improve metabolic and mental health outcomes in patients with type 2 diabetes.

Emotional overeating affected nine in ten female students during the COVID-19 university closure: A cross-sectional study in France

OBJECTIVES

To estimate the proportion of female university students reporting overeating (EO) in response to emotions during the COVID-19 university closures, and to investigate social and psychological factors associated with this response to stress.

DESIGN

Online survey gathered sociodemographic data, alcohol/drugs use disorders, boredom proneness and impulsivity using validated questionnaires, and EO using the Emotional Overeating Questionnaire (EOQ) assessing eating in response to six emotions (anxiety, sadness, loneliness, anger, fatigue, happiness), whose structure remains to be determined.

PARTICIPANTS

Sample of 302 female students from Rennes University, France.

MAIN OUTCOME MEASURE

Frequencies of emotional overeating.

ANALYSIS

The frequency of emotional overeating was expressed for each emotion as percentages. Exploratory Factor analyses (EFA) were used to determine EOQ structure and provide an index of all EOQ items used for further analysis. Linear regression models were used to explore relationships between EO and others covariates.

RESULTS

Nine in ten participants reported intermittent EO in the last 28 days, mostly during 6 to 12 days, in response to Anxiety (75.5%), Sadness (64.5%), Happiness (59.9%), Loneliness (57.9%), Tiredness (51.7%), and to a lesser extent to Anger (31.1%). EFA evidenced a one-factor latent variable reflecting "Distress-Induced Overeating" positively correlated with internal boredom proneness, tobacco use, attentional impulsivity, inability to resist emotional cues, and loss of control over food intake, and negatively with age and well-being. EO was unrelated to body mass index or substance abuse.

CONCLUSION AND IMPLICATIONS

Nine in ten female students reported emotional overeating during the COVID-19 university closure. This response to stress was related to eating tendencies typical of young women, but also to personality/behavioral patterns such as boredom and impulsivity proneness. Better understanding of the mechanisms underlying EO in response to stress and lack of external/social stimulation would improve preventive interventions.

The effect of emotion regulation on emotional eating among undergraduate students in China: The chain mediating role of impulsivity and depressive symptoms

This study aimed to examine the relationship between difficulties in emotion regulation and emotional eating and the role of impulsivity and depressive symptoms in mediating this chain. Four hundred ninety-four undergraduate students participated in the study. A self-designed questionnaire was used in the survey from February 6 to 13, 2022, to finish our purpose, including the Emotional Eating Scale (EES-R), Depression Scale (CES-D), Short Version of the Impulsivity Behavior Scale (UPPS-P) and Difficulties in Emotion Regulation Scale (DERS). The results showed that 1) difficulties in emotion regulation, impulsivity, depressive symptoms, and emotional eating were correlated; 2) impulsivity and depressive symptoms separately mediated the relationship between difficulties in emotion regulation and emotional eating; 3) impulsivity and depressive symptoms played a chain mediating role between difficulties in emotion regulation and emotional eating. The current study provided a better understanding of the psychologically related pathway of emotional eating. The results would be helpful for prevention and intervention of emotional eating among undergraduate students.

Eating when depressed, anxious, bored, or happy: An examination in treatment-seeking adults with overweight/obesity

Emotions that differ in valence are uniquely associated with eating. In our previous study with an online sample of adults with overweight/obesity, eating in response to depression was the type of emotional eating most closely associated with negative psychosocial correlates (Braden et al., 2018). The current study extended this research by examining associations between emotional eating types (eating in response to depression, anxiety, boredom, happiness) and psychological correlates among treatment-seeking adults. The present study was a secondary analysis of adults (N = 63; 96.8% female) with overweight/obesity and self-identified emotional eating who completed a baseline assessment for a behavioral weight loss intervention. Emotional eating in response to depression (EE-depression), anxiety/anger (EE-anxiety/anger), and boredom (EE-boredom) were assessed with the revised Emotional Eating Scale (EES-R), and positive emotional eating (EE-positive) was assessed with the positive emotions subscale of the Emotional Appetite Questionnaire (EMAQ). The Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale (BES), Difficulties in Emotion Regulation Scale (DERS), and Patient Health Questionnaire-9 (PHQ-9; depressive symptoms) were also administered. Frequencies showed the most endorsed emotional eating type was EE-depression (44.4%; n = 28). Four multiple regression analyses examined associations between emotional eating (EE-depression, EE-anxiety/anger, EE-boredom, and EE-positive) and dependent variables (EDE-Q, BES, DERS, and PHQ-9). Results showed that depression was the emotional eating type most closely related to disordered eating, binge eating, and depressive symptoms. Eating in response to anxiety was closely related to emotion regulation difficulties. Positive emotional eating was related to less depressive symptoms. Exploratory analyses showed that lower levels of positive emotional eating were related to higher depressive symptoms among adults with greater emotion regulation difficulties. Researchers and clinicians may consider tailoring weight loss treatment based on unique emotions that trigger eating.

Music as an alternative self-regulation strategy to snack foods following a negative mood induction in 5-7-year-old children: Interactions with parental use of food as a reward

This study aimed to extend studies that have looked at snack food consumption following a negative mood induction, and examine whether listening to a happy song would counteract food consumption in children. A second aim was to examine whether parental feeding practices (use of food as a reward and the use of food to regulate emotions) and child Body Mass Index (BMI) would moderate any differences. Eighty 5-7-year-old children took part in a negative mood induction and were then assigned to either a happy music condition or a silent control condition. The weight (g) consumed of four snack foods was measured (fruit hearts, crisps, chocolate biscuits, and breadsticks). Parents filled in baseline measures of feeding practices. There were no significant differences in food consumption between conditions. There was, however, a significant interaction between the high use of food as a reward and the condition on the amount of food eaten. In particular, following a negative -mood induction, those children whose parents reported using food as a reward and who were in the silent condition ate significantly more snack foods. There were no significant interactions with child BMI or with parental use of food to regulate emotions. This research suggests that the use of certain parental strategies may influence how children respond to novel emotion regulation techniques. Further research is needed to evaluate the best types of music to regulate emotions in children, and whether parents can be encouraged to replace maladaptive feeding practices with more adaptive non-food practices.

The impact of COVID-19 pandemic on food habits and neophobia in children in the framework of the family context and parents' behaviors: A study in an Italian central region

Objective

This paper aims to evaluate whether changes in lifestyle and eating habits resulting from the Covid-19 emergency have influenced the post-pandemic level of food neophobia and in children living in an Italian central region.

Methods

A sample of 99 children took part in a retrospective assessment carried out with a self-administrated questionnaire. Pre and post-pandemic evaluation of eating habits, physical activity, and lifestyle indicators was carried out. Food neophobia was evaluated following the Child Food Neophobia Scale (CFNS). Descriptive statistics were produced. A contingency analysis was performed to check associations between variables.

Results

For a large part of the sample (97%) the selective food refusal did not change during the pandemic period. About 70% of participants did not change their eating habits, with some subgroups reporting an increase in the consumption of fruits (22.2%), vegetables (19.2%), and legumes (21.2%). Relevantly the impact of the pandemic on the sedentary attitude passed from 25.3 to 70.7%. Neophobia was not associated with ponderal status (p-value 0.5). However, in normal-weight children, a high prevalence of intermediate-level neophobia (78.4%) was found. 39.4% of the studied children were involved in meal preparation during social isolation, with an increase in the proportion of children that shared all meals with their family (32.3% vs. 78.8%). Non-coercive parent behaviors in reaction to food refusal were associated with low levels of neophobia (p-value < 0.05).

Discussion

In this sample, for the effect of parents' attitudes, the pandemic positively affected children's food habits and, consequently, the level of neophobia after the social restrictions. The main implication of the study is the importance of capitalizing on the period of restrictions in order to involve children in meal sharing and food preparation.

Body perceptions, occupations, eating attitudes, and behaviors emerged during the pandemic: An exploratory cluster analysis of eaters profiles

Introduction

COVID-19 pandemic negatively impacted people's mental and physical health. Three areas have been significantly impacted, among others: eating-related behaviors, occupational balance, and exposure to self-image due to videoconferencing. This study aims to explore and document eaters profiles that were reported during the pandemic in the general Canadian population using a holistic perspective, including body perceptions, attitudes, and eating behaviors (i.e., body image, behaviors, attitudes, and motivations regarding food), and occupations (i.e., physical activity and cooking).

Methods

This cross-sectional study was conducted from May to September 2020. Two hundred and seventy-three Canada's residents, French speaking of 18 years of age and older, participated in an online survey on behaviors, attitudes, and motivations regarding food and eating as well as body image and occupations during the COVID-19 pandemic. A hierarchical cluster analysis was used to determine the eaters profiles. One-way ANOVA and Chi-square test were conducted to differentiate occupational characteristics between eaters profiles.

Results

Three distinctive profiles were found during the COVID-19 pandemic and could be placed on a continuum: the Congruent-driven eater is at the functional pole of the continuum, whereas the Incongruent-driven eater is at the dysfunctional pole of the eaters continuum. In the middle of the continuum, the Incongruent-perceptual eater is at a critical crossing point. Significant differences were reported between eaters profiles.

Discussion

The empirical results based on an eaters continuum conceptualization highlight the importance of understanding how people perceive their body to assess and promote food well-being.

Dietary changes among pregnant individuals compared to pre-pandemic: A cross-sectional analysis of the Pregnancy during the COVID-19 Pandemic (PdP) study

Introduction

Dietary changes are common in pregnancy and may affect pregnancy outcomes, yet these changes and the associated contributory factors during the COVID-19 pandemic have been understudied. We aimed to investigate the association between dietary change and socioeconomic variables, pre-pregnancy BMI, and mental health symptoms; the change in intake of seven food categories and their reasons; and the association between intake of these food categories and mental health symptoms.

Materials and methods

In this cross-sectional analysis, we used data from the Pregnancy during the COVID-19 Pandemic (PdP) cohort study that collected data from pregnant Canadian individuals (n = 9,870, gestational age ≤ 35 weeks) on socioeconomic factors, pandemic-related hardships, pre-pregnancy body mass index (BMI), dietary changes compared to pre-pandemic and the reasons for these changes. We assessed depressive and anxiety symptoms using the Edinburgh Postpartum Depression Scale (EPDS) and Patient-Reported Outcomes Measurement Information System (PROMIS)-Anxiety, respectively.

Results

54.3% of the participants reported a change in their diet. Non-white ethnicity (OR = 1.33), job loss (OR = 1.29), clinically elevated depressive and anxiety symptoms (OR = 1.26 and 1.14, respectively), self-isolation (OR = 1.20), pre-pregnancy BMI (OR = 1.19), fear of COVID-19 (OR = 1.15), and pandemic phase at enrolment (OR = 0.90) significantly predicted dietary change. Most participants ate about the same amounts of dairy, meats and canned foods/dried goods as pre-pandemic (61.5, 61.7, and 60.2%, respectively), increased their intake of fresh vegetables/fruits and sweets/snacks (43.2 and 54.5%, respectively), and decreased fast-food and take-out/home delivery (53.2 and 43.1%, respectively). Changes in consumption of the food categories had a curvilinear association with mental health symptoms (except resilience) indicating greater symptoms with either decreased or increased intakes. Changes in craving, having more time for cooking/preparing foods, and being unable to go grocery shopping frequently (but not reduced affordability) were the main reasons driving these dietary changes.

Conclusion

Some factors increase the odds of dietary change among pregnant individuals during the pandemic, with some changes toward a healthy and others toward an unhealthy diet. Given the importance of a healthy diet during gestation, identifying the risk and protective factors might be the first essential step in reducing the detrimental effects of unfavorable dietary changes during the pandemic on this vulnerable population.

Snacking for a reason: detangling effects of socio-economic position and stress on snacking behaviour

BACKGROUND

As snacking can be considered a cornerstone of an unhealthy diet, investigating psychological drivers of snacking behaviour is urgent, and therefore the purpose of this study. Socio-economic position (SEP) and stress are known to affect many behaviours and outcomes, and were therefore focal points in the study.

METHODS

In a cross-sectional survey study, we examined whether Socio-economic position (SEP) would amplify associations between heightened stress levels and self-reported negative-affect related reasons for snacking. Next, we investigated whether Socio-economic position (SEP) predicted frequency of snacking behaviour, and how stress and other reasons for snacking could explain this association. Outcome measures were reasons people indicated for snacking, and frequency of snacking behaviour.

RESULTS

Analyses revealed that people seem to find more reasons to snack when they are stressed, and that this association was more pronounced for people with a high compared to low socio-economic position. Furthermore, a higher socio-economic position was associated with a higher frequency of snacking, and both snacking to reward oneself and snacking because of the opportunity to do so remained significant mediators.

CONCLUSION

Whereas low socio-economic position was associated with higher stress levels, this did not translate into increased snacking. Contrarily, those with higher socio-economic position could be more prone to using 'reasons to snack', which may result in justification of unhealthy snacking behaviour.

A Comparison of Emotional Triggers for Eating in Men and Women with Obesity

OBJECTIVE

Emotional eating (EE) is prevalent in people seeking obesity treatment and is a contributor to poor weight loss outcomes. We aimed to delineate the emotions most associated with this type of eating, and whether they differ by sex in people undergoing obesity treatment.

METHODS

A cross-sectional study recruiting 387 adults from a hospital obesity management service. Emotional eating was measured using the Emotional Eating Scale (EES). Separate analyses included all participants, and those undergoing lifestyle interventions alone or in combination with obesity medication and/or bariatric surgery.

RESULTS

A total of 387 people (71% women) participated in the study (n = 187 receiving lifestyle modification alone; n = 200 in combination with additional treatments). Feeling 'bored' was most commonly and most strongly associated with the urge to eat, regardless of sex or treatment. Women had higher scores for total EES, for subscales of depression and anger, and individual feelings of 'blue', 'sad' and 'upset' compared to men.

CONCLUSIONS

Understanding why certain emotions differentially trigger an urge to eat in men and women, and finding strategies to break the link between boredom and eating may enable better personalisation of lifestyle interventions for people with obesity.

Ugly food, not eat: the eating intention of emotional eater for different esthetic food

BACKGROUND

Emotional eaters eat to relieve their emotions. However, food also contains esthetic information. People generally perceive ugly food as unhealthy and unpalatable. Does the esthetic information of food influence an emotional eater's desire for food in a negative emotional state? In particular, do they have the same lower eating intentions for low esthetic food as non-emotional eaters?

OBJECTIVE/DESIGN/MEASURES

Based on these questions, the present study examined whether the esthetic value of food influences emotional eaters' desires for food. The experiment used a 2 (eating type: emotional eating vs. non-emotional eating) × 2 (food style: high esthetic vs. low esthetic) mixed experimental design. We measured the emotional and non-emotional eaters' eating intentions for different esthetic foods when experiencing negative emotions.

RESULTS

The results showed that emotional eaters have higher intention to eat high esthetic foods. However, they did not have a high eating intention for all foods, and their eating intention did not differ from that of non-emotional eaters when faced with low esthetic food.

CONCLUSION

In conclusion, food esthetic value can affect individual eating intentions. Even for emotional eaters who are in a negative mood, they also did not have a higher eating intention for low esthetic food compared with no-emotional eater.

LEVEL OF EVIDENCE

Level II: controlled trial without randomization.

Disordered eating among college students: The effects of parental attachment and the mediating role of emotion dysregulation

ObjectivesThe current study explored the relationship between parental attachment and disordered eating among college students. This study also explored the potential mediating role of factors associated with emotion regulation. Participants: One hundred sixty-seven undergraduates (M = 18.93 years, SD = 1.02) participated in the current study. Methods: Participants completed an anonymous questionnaire reporting their perceptions of their parental attachment relationships, emotional reactivity, difficulty regulating emotions, and disordered eating. Results: Analyses using structural equation modeling indicated that difficulty regulating emotions mediated the relationship between maternal attachment and disordered eating, but not between paternal attachment and disordered eating. Emotional reactivity did not emerge as a significant mediator. Conclusions: These findings suggest that maternal attachment relationships may be associated with difficulty regulating emotions in adulthood, which may in turn impact disordered eating attitudes and behaviors.

Burden of Nutritional Deficiencies in China: Findings from the Global Burden of Disease Study 2019

From 1990 to 2019, the age-standardized incidence rate of nutritional deficiencies in China remained stable. However, the age-standardized disability-adjusted life-years (DALY) rate of nutritional deficiencies decreased from 1990 to 2019. Data were extracted from the GBD 2019 datasets. Estimated annual percentage changes (EAPCs) were calculated to assess the incidence rate, and DALY trends of nutritional deficiencies. Measures were stratified by subtypes, regions, and age groups. In 2019, the age-standardized DALY rates of dietary iron deficiency and protein-energy malnutrition reached their highest levels. The main population groups with protein-energy malnutrition and dietary iron deficiency were adults over the age of 70 and children under the age of five. The latter group also had a greater burden of vitamin A deficiency. Zhejiang, Beijing, and Guangdong reported the highest age-standardized incidence rates of nutritional deficiencies, which mainly pertained to protein-energy malnutrition and vitamin A deficiency. Tibet, Xinjiang, and Hainan had the highest age-standardized DALY rates of nutritional deficiencies, which mainly pertained to dietary iron deficiency and protein-energy malnutrition.

Boredom is the root of all evil-or is it? A psychometric network approach to individual differences in behavioural responses to boredom

Functional accounts of boredom propose that boredom serves as an impartial signal to change something about the current situation, which should give rise to adaptive and maladaptive behaviour alike. This seemingly contrasts with research on boredom proneness, which has overwhelmingly shown associations with maladaptive behaviour. To shed light on this discrepancy, we disentangled boredom proneness from individual differences in (i) the urge to avoid and escape boredom and (ii) adaptive and maladaptive ways of dealing with boredom by developing corresponding trait scales. In a study with N = 636 participants, psychometric network modelling revealed tight associations between boredom proneness and less adaptive and (especially) more maladaptive ways of dealing with boredom. However, its associations with the urge to avoid and escape boredom were rather weak. Importantly, a higher urge to avoid and escape boredom was linked not only to more maladaptive but also to more adaptive ways of dealing with boredom. This pattern of results was robust across various specific behaviours that have previously been linked to boredom. Our findings provide novel evidence for functional accounts of boredom from an individual difference perspective, cautioning against a shallow view of boredom as being associated with purely maladaptive behaviour.

The Struggle to Entertain Yourself: Consequences of the Internal Stimulation Factor of Boredom Proneness during Pandemic Lockdown

Boredom is a ubiquitous human experience that most people try to avoid feeling. People who are prone to boredom experience negative consequences. This study examined the impact of individual differences in the ability to entertain the self (the internal stimulation factor) on boredom experiences during the COVID-19 lockdown in the United States. The internal and external stimulation factors predicted greater boredom frequency, boredom duration, and boredom intensity, each of which reflected a different aspect of emotional experience. The relationship among these factors was complex. A serial mediation analysis indicated the internal stimulation factor predicted the frequency of boredom, which in turn predicted the duration of boredom, which predicted boredom intensity. This pattern of relationships is potentially unique to boredom among emotional experiences. These findings provide insight into how boredom functions during a period in which daily activities and coping resources that would normally be available became severely limited.

Time estimation and passage of time judgment predict eating behaviors during COVID-19 lockdown

Poor eating habits often lead to health concerns. While mental health conditions such as stress and anxiety have been linked as predictors for eating behaviors, cognitive factors may also contribute to eating practices during the early stages of the mandatory COVID-19 lockdown. In the current study, participants responded to a survey that asked them to judge the passing of time (PoTJ) and to produce short intervals (via a time production task) as an index of the internal clock speed. Additionally, they responded to questions about snacking frequency and the tendency to overeat during lockdown. We observed that those who judged time to pass slowly also reported a greater tendency to snack and overeat during the pandemic. Additional analysis also revealed that the effect of PoTJ on snacking is moderated by the internal clock speed such that those who felt time was passing by slowly, and in combination with a faster internal clock (as indexed by shorter duration production), had a greater tendency to snack. The results suggest that different aspects of temporal cognition play potential roles in influencing different types of eating behaviors. Our findings therefore have implications for eating disorders, along with the potential of time-based intervention or behavioral modification approaches.

Boredom in a Time of Uncertainty: State and Trait Boredom's Associations with Psychological Health during COVID-19

Throughout the COVID-19 pandemic, studies have demonstrated increases in boredom and its negative impact on mental health. This cross-sectional study examines state and trait boredom at four different points of the pandemic using an online sample of participants from the United States (n = 783). The results showed significant increases in boredom proneness, state boredom, substance use, loneliness, and distress. Boredom was associated with increases in each of these variables and a greater likelihood of testing positive for COVID-19. Moreover, the increases in distress, loneliness, and substance use became non-significant when controlling for boredom. Boredom proneness remained associated with all adverse outcomes when accounting for state boredom. In contrast, the relationships between state boredom and most adverse outcomes lost significance when controlling for boredom proneness, and state boredom was positively associated with increased hope for the future. Overall, the results suggest that high boredom proneness is an important vulnerability factor for poor psychological health and risky behaviors during the pandemic. However, high levels of recent state boredom, independent of boredom proneness, do not predict similarly negative outcomes. State boredom may indicate the extent to which one remains hopeful that circumstances will improve without resorting to risky, potentially maladaptive coping strategies.

Prevalence of Emotional Eating in Groups of Students with Varied Diets and Physical Activity in Poland

Background: Emotional eating (EE) is not a separate eating disorder, but rather a type of behavior within a group of various eating behaviors that are influenced by habits, stress, emotions, and individual attitudes toward eating. The relationship between eating and emotions can be considered on two parallel levels: psychological and physiological. In the case of the psychological response, stress generates a variety of bodily responses relating to coping with stress. Objective: Therefore, the main objective of this study was to evaluate and compare the prevalence of emotional eating in groups of students in health-related and non-health-related fields in terms of their differential health behaviors—diet and physical activity levels. Material and Methods: The cross-sectional survey study included 300 individuals representing two groups of students distinguished by their fields of study—one group was in health-related fields (HRF) and the other was in non-health-related fields (NRF). The study used standardized questionnaires: the PSS-10 and TFEQ-13. Results: The gender of the subjects was as follows: women, 60.0% (174 subjects) (HRF: 47.1%, n= 82; NRF: 52.9%, n = 92); men, 40.0% (116 subjects) (HRF: 53.4%, n = 62; NRF: 46.6%, n = 54). The age of the subjects was 26 years (±2 years). Based on the results of the TFEQ-13, among 120 subjects (41.4%) there were behaviors consistent with limiting food intake (HRF: 72.4%; NRF: 11.0%), while 64 subjects (20.7%) were characterized by a lack of control over food intake (HRF: 13.8%, 20 subjects; NRF: 27.4%, 20 subjects). Emotional eating was characteristic of 106 students (37.9%), with the NRF group dominating (61.6%, n = 90). It was observed that a high PSS-10 score is mainly characteristic of individuals who exhibit EE. Conclusions: The results obtained in the study indicate that lifestyle can have a real impact on the development of emotional eating problems. Individuals who are characterized by elevated BMI values, unhealthy diets, low rates of physical activity, who underestimate meal size in terms of weight and calories, and have high-stress feelings are more likely to develop emotional eating. These results also indicate that further research in this area should be undertaken to indicate whether the relationships shown can be generalized.

Associations between Resilience and Food Intake Are Mediated by Emotional Eating in the NutriNet-Santé Study

BACKGROUND

Resilience, the ability to bounce back or recover from stress, has been associated with several health-related behaviors. However, data on food intake and emotional eating are lacking.

OBJECTIVES

The objective of this cross-sectional study was to analyze the associations between resilience and diet quality and ultraprocessed food (UPF) and food group consumption, and to assess whether emotional eating was a mediator of these associations.

METHODS

In 2017, 17,840 participants (73.5% female, mean age = 55.4 ± 14.0 y) of the NutriNet-Santé study completed the Brief Resilience Scale, the revised 21-item Three-Factor Eating Questionnaire, and ≥3 self-administered 24-h dietary records. Diet quality was assessed with the modified French National Nutrition and Health Program Guideline Score. Foods and beverages consumed were categorized according to their degree of processing by the NOVA classification. We assessed the association between resilience and emotional eating using linear regression models. We also assessed the mediating role of emotional eating in the associations between resilience and diet quality, energy intake, and UPF and food group consumption, controlling for sociodemographic characteristics.

RESULTS

In our study, resilience was negatively associated with emotional eating (P < 0.0001). More resilient participants had greater overall diet quality, greater intakes of seafood, whole-grain foods, fats, unsalted oleaginous fruits, and alcoholic beverages, and lower intakes of UPFs, starchy foods, dairy desserts, sugary fatty products, and sugar and confectionery (all P < 0.05). Emotional eating was a mediator of the inverse associations between resilience and intake of energy, UPFs, dairy desserts, sugary fatty products, and of the positive associations between resilience and alcoholic beverages (all P < 0.05), with a 20-70% mediation.

CONCLUSIONS

Our findings showed that resilience was associated with an overall better diet quality in the NutriNet-Santé population-based study. These associations were partially explained by emotional eating. These findings suggest that resilience should be considered in the promotion of healthy dietary habits.The study is registered at clinicaltrials.gov as #NCT03335644.

Boredom belief moderates the mental health impact of boredom among young people: Correlational and multi-wave longitudinal evidence gathered during the COVID-19 pandemic

Objectives

Young people's experience of boredom and its psychological health sequelae have been exacerbated by the COVID‐19 pandemic. The present study examined the moderating role of boredom beliefs—the extent to which one affectively dislikes boredom (boredom dislike) and cognitively accepts it (boredom normalcy)—on the association between boredom experience and mental well‐being. We also validated a new measure of boredom beliefs in two different samples of young people.

Method

We report data from a correlational study with British young people aged 12–25 (Study 1; N = 2495) and a 16‐week eight‐wave within‐subject study with Israeli adolescents aged 12–18 (Study 2; N = 314).

Results

Across both studies, disliking boredom was associated with higher frequency and intensity of boredom. Boredom dislike moderated the negative association between boredom and mental well‐being, such that the association was more salient among those who strongly disliked boredom. Normalizing boredom was positively associated with mental well‐being. The measure of boredom beliefs demonstrated fair validity and reliability.

Conclusion

Results provide novel insights into the potential buffering effect of boredom beliefs against the mental health impact of boredom, particularly at a time of reduced activity. These findings generalize across two different countries.

Changes in dietary patterns among Bangladeshi adult population during the COVID-19 pandemic: A web-based cross-sectional study

Background

The home confinement induced by the COVID-19 pandemic affects individuals’ mental wellbeing and increases unhealthy behaviors, such as minimum to no physical activity, overeating, and substance use.

Objective

This study aimed to assess the changes in dietary patterns among the Bangladeshi adult population during the COVID-19 pandemic and identify their determinants.

Methods

This web-based cross-sectional survey was carried out from 10–17 December 2020 using an e-questionnaire based on Google Forms. A semi-structured e-questionnaire was forwarded to the participants – Bangladesh citizens aged above 18 years – through social media platforms and email in order to collect information about socio-demographic issues and multidimensional dietary patterns. From the initial 817 responses gathered through snowball sampling, 748 responses were retained. Bivariate and multivariate analyses were executed.

Results

The findings suggest that 50% of the participants reported a reduction in weight and physical activities, while approximately 52% experienced increased sleep time. One in three participants (31.4%) experienced a decrease in food buying capacity. The findings further indicate that women were 1.65 times more likely to reduce food consumption than men. Meanwhile, employed people were about 34% less likely to increase food consumption than their unemployed counterparts. People who were getting more than 6 h of sleep per day were nearly 61% less likely to increase food consumption than people who slept for less than 6 h per day. People struggling to buy food items were 2.31 times more likely to reduce food intake than people with no such limitations.

Conclusions

The study shows that COVID-19 has substantially affected Bangladeshi people’s common food consumption patterns. Being confined within the household, primarily due to countrywide lockdowns and ‘general holidays’, has affected both the dietary patterns and the financial wellbeing of people. Therefore, the concerned authorities should promote effective nutrition education and healthy dietary behaviors; meanwhile, financial support or incentives for people in need are also strongly advocated.

Role of Alexithymia in Predicting Internet Novel Addiction through Boredom Proneness

With the development of the internet, people’s pursuit of reading entertainment has enriched internet novels, but the relevant influencing factors are still unclear. Therefore, we recruited 344 Chinese college students and employed a questionnaire survey to explore the relationship between alexithymia, boredom proneness, and internet novel addiction. The results showed that (1) there was no significant difference between female and male college students in terms of alexithymia and boredom proneness, whereas male college students had a higher total score of internet novel addiction than females. (2) There were significant positive correlations between alexithymia, boredom proneness, and internet novel addiction. (3) Boredom proneness played a partial mediating role in the impact of alexithymia on the internet novel addiction. Taken together, alexithymia may directly and indirectly predict internet novel addiction through boredom proneness.

Boredom proneness, interoception, and emotional eating

Emotional eating is associated with weight gain and difficulty losing weight during weight loss interventions. Theoretical and empirical work suggest boredom may be an important predictor of problematic eating behaviors. Yet, little work has examined the role of boredom in emotional eating. Further, individual differences in the ability to recognize internal cues (i.e., interoception) may alter the impact of boredom on emotional eating. This study hypothesized that boredom proneness would predict unique variance in emotional eating after accounting for negative and positive affect, and that the association between boredom proneness and emotional eating would be stronger among those with poorer interoceptive ability compared to those with better interoceptive ability. Hypotheses were tested in two large samples using multiple linear regression. Participants aged 18-65 were recruited from MTurk (n = 365; 59.2% female) and an undergraduate research pool (n = 461; 52.9% female). Participants completed self-report measures: Boredom Proneness Scale; Dutch Eating Behavior Questionnaire- Emotional Eating; Multidimensional Assessment of Interoceptive Awareness-2; Intuitive Eating Scale-2- Reliance on Hunger and Satiety Cues; and Positive and Negative Affect Schedule. Boredom proneness was a significant predictor of emotional eating in both samples, even accounting for the broad dimensions of negative and positive affect (ps < .001). Interoception did not moderate the association between boredom proneness and emotional eating in either sample (ps > .05), but was an independent predictor of emotional eating (ps < .001). Boredom proneness and interoceptive ability may warrant attention as targets in the prevention and treatment of emotional eating. Future work should continue exploring different emotion categories and different facets of interoception in emotional eating, as well as examine novel mechanisms that could inform intervention efforts.

Impact of COVID-19 lockdown on food habits, Appetite and body weight in tunisian adults

Tunisia recorded the highest rate of COVID-19 positive cases and deaths in Africa but no studies assessed the impact of the pandemic on eating patterns as in the case of several countries. The objective of the present study was to investigate the perception of changes in food habits, appetite and body weight in Tunisian adults of both genders aged 20–74 years old. A cross-sectional study has been carried out with a non-probabilistic sampling method based on an online self-administered survey. Of overall 1082 adults included in the study, 57⋅8 % reported a change in their eating habits: 21⋅2 % an increase in their consumption of fresh fruits, vegetables, pulses, pasta and bread, while 36⋅6 % an increase of homemade cakes and biscuits, sweets, processed meat, sugary drinks and alcoholic drinks. In addition, tea, coffee and herbal tea have been reported as excessively consumed during the lockdown period. More than half experienced appetite variations (34⋅6 % increased appetite and 23⋅0 % appetite loss). Inequality detrimental to women was reported regarding eating habit changes (women consumed more unhealthier foods than men). Elderly subjects (over 60 years) were less likely to negatively change food habits in comparison with young adults (20–25 years), while ungraduated respondents were more prone to negatively change their food habits. Almost half reported weight gain. As the negative influence of the lockdown period on eating habits with the increase of obesity risk has been detected, health policy may be advised to focus on using mass media campaigns to promote healthy eating habits, in particular for illiterate and young people.

The Role of Selected Psychological Factors in Healthy-Sustainable Food Consumption Behaviors during the COVID-19 Pandemic

The COVID-19 pandemic and the consequent precautions and dispositions adopted have triggered substantial changes in daily health-related behaviors, including food consumption habits. The psychological impact of the pandemic has been considered one of the factors affecting this transition and requiring consideration when targeting healthy-sustainable behavior preservation. The present study describes the results of a survey conducted on a convenience sample of Italian residents (n = 2272) during the first phases of pandemic. The aim was to explore the daily nutritional choices and behaviors and their transformations that occurred along with the associations with psychological factors (i.e., subjective well-being, and depression, anxiety and stress symptoms). An indicator for healthy-sustainable transition (HST index) was constructed and revealed diffused transformation in dietary habits, with a large segment of the sample adopting healthier and more sustainable dietary behaviors and others showing reduced healthy-sustainable food choices. Informative relationships with the psychological variables were then found from the correlational and regression analyses. Lower levels of anxiety, depression and stress symptomatology and higher perceived subjective well-being were significantly associated with healthier-sustainable food consumption behaviors. These findings shed light on the crucial areas to be considered in future institutional interventions, ultimately ensuring favorable conditions for both healthy diet behaviors and sustainable food consumption choices.

Psychosocial factors affecting dietary habits of university students: A cross-sectional study

Background

University student transition from living at home to more independent living which might influence their eating habits. This study aims to assess the effect of psychosocial factors on eating habits among university students.

Methods

A cross-sectional study was conducted among 529 students at the University of Sharjah. Participants completed a self-administered questionnaire on dietary habits, social, and psychological factors. The height and weight were also measured.

Results

More than one-third of participants were classified as overweight or obese (37.6%) and 39.1% reported not engaging in regular physical activity. Less than half of the participants consumed breakfast daily (45.4%) and 83.2% consumed less than two liters of water per day. Only 28.7% and 34.0% of participants consumed fruits and vegetables daily, respectively. Almost 80% of participants reported eating when they were bored, 83.7% ate when feeling happy, and 56.5% ate when they were sad. Eating habits score was significantly lower among unmarried participants (p = 0.03), those not living with their family (p < 0.001), smokers (p = 0.001), those not engaging in regular physical activity (p < 0.001), and those who reported eating uncontrollably (p = 0.007).

Conclusions

Psychosocial factors were important indicators of dietary habits among students. Implementing nutrition education campaigns and health-related courses at the university are recommended.

Impact of Prolonged COVID-19 Lockdown on Body Mass Index, Eating Habits, and Physical Activity of University Students in Bangladesh: A Web-Based Cross-Sectional Study

Objectives

This current study aims to assess the prevalence and factors associated with body mass index (BMI), dietary patterns, and the extent of physical activities among university students following the prolonged coronavirus disease 2019 (COVID-19) lockdown in Bangladesh.

Methods

A cross-sectional web-based survey was conducted between July 10 to August 10, 2021, through a pre-designed Google Form to collect the data from Bangladeshi university students (age: ≥18 years). Informed consent was electronically obtained from each participant, and a simple snowball technique was employed during the sampling. Frequency and percentage distribution, paired t-test, chi-square [χ²] test, and multinomial and binary logistic regression analyses were consecutively applied to analyze the collected data.

Results

Among the total participants (n = 1,602), 45.1% were female and 55.6% were 22–25 years' age group students. The BMI (mean ± standard deviation, SD) during the COVID-19 lockdown was 23.52 ± 7.68 kg/m², which was 22.77 ± 4.11 kg/m² during the pre-lockdown period (mean difference = 0.753; p < 0.001). The multinomial logistic regression analysis found a significant impact of gender [male vs. female: adjusted relative risk ratio (RRR) = 1.448; 95% confidence interval (CI) = 1.022, 2.053; p = 0.037], age (years) (<22 vs. >25: RRR =0.389, 95% CI = 0.213,0.710; p = 0.002, and 22–25 vs. >25: RRR = 0.473, 95% CI = 0.290, 0.772; p = 0.003), monthly family income (BDT) (<25,000 vs. >50,000: RRR = 0.525, 95% CI = 0.334,0.826; p = 0.005), university type (public vs. private: RRR = 0.540, 95% CI = 0.369, 0.791; p = 0.002), eating larger meals/snacks (increased vs. unchanged: RRR = 2.401, 95% CI = 1.597, 3.610; p < 0.001 and decreased vs. unchanged: RRR = 1.893, 95% CI = 1.218, 2.942; p = 0.005), and verbally or physically abuse (yes vs. no: RRR = 1.438, 95% CI = 0.977, 2.116; p = 0.066) on obesity during COVID-19 pandemic. Besides, the female students and those who have constant eating habits, were more likely to be underweight. Additionally, the binary logistic regression analysis found that the students from private universities [others vs. private: adjusted odds ratio (AOR) = 0.461, 95% CI = 0.313, 0.680; p < 0.001], urban areas (urban vs. rural: AOR = 1.451, 95% CI = 1.165, 1.806; p = 0.001), wealthier families (<25,000 BDT vs. >50,000 BDT: AOR = 0.727, 95% CI = 0.540, 0.979; p = 0.036), and who were taking larger meals/snacks (increased vs. unchanged: AOR = 2.806, 95% CI = 2.190, 3.596; p < 0.001) and had conflicts/arguments with others (no vs. yes: AOR = 0.524, 95% CI = 0.418, 0.657; p < 0.001), were significantly more physically inactive. Finally, the level of education and smoking habits significantly influenced the eating habits of university students during the extended strict lockdown in Bangladesh.

Conclusion

The current findings would be helpful tools and evidence for local and international public health experts and policymakers to reverse these worsening effects on students mediated by the prolonged lockdown. Several effective plans, programs, and combined attempts must be earnestly implemented to promote a smooth academic and daily life.

Emotion Regulation Difficulties and Health-Risk Behaviours in Adolescents

Health-Risk Behaviours (HRBs) are significantly associated with avoidable mortality in adolescents, and preventing HRBs requires an adequate understanding of related factors. Among associated factors, emotion regulation difficulties may impact youths’ engagement in HRBs. Researchers explored the relation of emotion regulation with HRBs; however, specific emotion regulation difficulties for less severe and more prevalent HRBs, such as self-harming behaviour, risky-driving, violence, unhealthy dietary behaviour, and poor adherence to prescribed medication, has not been much explored. The current study aimed to explore the predictability of adolescents’ specific difficulties in emotion regulation in relation to their engagement in HRBs. For this purpose, six different HRBs, that is, self-harm, violence, risky-driving, unhealthy dietary behaviour, inadequate physical activity, and lack of medication adherence, were studied. A total of 617 (Males = 356) adolescents (Mage = 15.77) from five districts of Punjab state (India) provided required information on standardised self-report measures. The data were subjected to regression analysis, and the findings show that the participants who scored high on emotion regulation difficulties reported engagement in HRBs more than their counterparts. Some specific difficulties are more important than others for different forms of HRBs. It implies that the intervention programmes targeting specific HRBs should address specific facets of emotional dysregulation.

Solid or Liquid Food-The Intention to Eat Different Foods under Negative Emotions

Food can relieve an individual's emotions, especially for emotional eaters. For instance, chewing alleviates negative emotions. Solid and liquid foods comprise a huge part of our daily lives, and the chewiness of solid foods is always high. Here, we explored whether people, especially emotional eaters, have higher eating intentions to eat highly chewy foods while experiencing negative emotions by comparing their eating intentions toward solid and liquid foods. To this end, we conducted a survey of 147 participants using a questionnaire (Experiment 1) to understand their eating intention toward five types of food (purple potato, maize, black soya bean, mango, and soybean; each food group contained a solid food and a liquid food) while experiencing negative emotions. The results showed that individuals exhibited higher eating intention toward solid food compared with liquid food while experiencing negative emotions. In Experiment 2, we selected 85 and 65 high-emotional and low-emotional eaters, respectively, and further explored their preference for solid foods. The results showed that individuals with high levels of emotional eating exhibited higher intentions toward solid food while experiencing negative emotions compared with those with low levels of emotional eating. In conclusion, this study proved that individuals' higher eating intentions toward highly chewable food were pronounced among individuals with high levels of emotional eating under negative emotion conditions.

The Relationship Between Women’s Negative Body Image and Disordered Eating Behaviors During the COVID-19 Pandemic: A Cross-Sectional Study

Recent studies have shed light on how the COVID-19 pandemic changed our lives, and most of them have documented its detrimental effect on eating habits. Until now, the effects of this global crisis on negative body image and its association with disordered eating behaviors remain largely understudied. This study aimed to investigate changes in frequency of disordered eating behaviors (i.e., restrictive eating, emotional eating, and overeating) and negative body image (i.e., shape and weight concern, and body dissatisfaction) among a community sample of women during the COVID-19 pandemic (October 2020–May 2021). Furthermore, we explored the possible relation between body image-related variables and changes in the frequency of disordered eating behaviors in the context of the pandemic. A total of 161 self-identified female participants enrolled in an online-based survey. Descriptive statistics showed that women did not report clinically significant levels of weight and body shape concerns, but participants reported being dissatisfied with their body. One sample Wilcoxon Signed Rank tests revealed a tendency toward an increasing of the frequency of all disordered eating behaviors during the COVID-19 pandemic. Multinomial logistic regressions showed that weight concerns predicted an overall increase in the frequency of restrictive eating behaviors, whereas higher body dissatisfaction was associated with a moderate self-perceived increase in the frequency of emotional eating. These results shed light on a risk pattern of phenomena in a non-clinical sample of women, as they represent the key risk factors for the development of eating disorders. Findings could have implications for designing and implementing prevention programs.

Alteration of dietary habits and lifestyle pattern during COVID-19 pandemic associated lockdown: An online survey study

Background & aim

A few population-based studies have looked at how the Corona virus disease (COVID-19) pandemic and outbreak-related lockdown has impacted people's daily eating habits and lifestyles. Due to the emergence of the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), continuous lockdown or social isolation can alter dietary consumption patterns and lifestyle routines, resulting in significant negative health consequences. Focused on the COVID-19 and disease related lockdown effects, this study aims to reflect the evolving trend in dietary habits and lifestyle status during the COVID-19 lockdown in West Bengal through a population mediated retrospective survey distributed via social media platforms.

Methods

This survey was conducted using Google form via online platform from July 7 to July 31, 2020, with 1059 participants reported their eating habits and lifestyle preferences, as well as basic socio-demographic details. Entire variables were qualitatively examined and uttered as frequency (f) and percentage (%). The Chi-square test was performed to conclude whether categorical variables differed.

Results

A high number of participants reported that they were consumed healthy foods and physically active during this pandemic situation. Females were more likely to be involved in exercise and consume protein-rich food, as well as the majority of them, maintain basic dietary and Ayurvedic home remedies precautions like consumption of lemon, consumption of herbs, taking warm water, etc. A majority of older participants were tried to maintain a healthy lifestyle with extra protective essential protection during the COVID-19 stage. The frequency of going to market was decreased by the participants. Females were more likely to decrease their frequency of going to market than males. In terms of hygiene and sanitization of food items after buying from the market, females were more careful than males. Participants with higher education were more likely to be careful regarding the hygiene of food preparation and eating during this situation.

Conclusion

From this study, dieticians, legislators, and public health experts can have a better understanding of the current situation of food intake and lifestyle trends in communities of West Bengal, India. It also has the potential to have a significant impact on future public health research.

The Relationship Between Fears of Compassion, Emotion Regulation Difficulties, and Emotional Eating in College Students: A Moderated Mediation Model

Although previous research has found the impact of fears of compassion on eating disorders, the mechanism underlying the relationship between fears of compassion and emotional eating remains to be examined. This study aimed to examine the mediating role of emotion regulation difficulties in the relationships between fears of compassion and emotional eating in college students, as well as the gender difference in the mediation model. The Fears of Compassion Scale, Difficulties in Emotion Regulation Scale, and Dutch Eating Behavior Questionnaire were completed by 673 college students in Fujian Province, China. Structural Equation Modeling was primarily employed to analyze the data. The results showed that both fear of compassion for self and fear of compassion from others were positively associated with emotion regulation difficulties, which in turn were related to emotional eating for female college students. Emotion regulation difficulties played a significant mediating effect in the relationship between fears of compassion and emotional eating. Comparatively, for male college students, only fear of compassion for self was positively associated with emotion regulation difficulties, but emotion regulation difficulties were not related to emotion eating. Moreover, the mediating effect of emotion regulation difficulties was not significant in the relationship between fears of compassion and emotion eating for male college students. The findings suggest that it is important to improve individuals' fears of compassion to reduce emotional eating, particularly for female college students.

Relationship between Emotional Eating, Consumption of Hyperpalatable Energy-Dense Foods, and Indicators of Nutritional Status: A Systematic Review

People's health is closely linked to their diet. Diet can be defined as the set of foods that are consumed in a day, and it is susceptible to being altered by various factors, such as physiological, environmental, psychological, and social. These, in turn, can be affected by an inadequate diet and/or a dysregulation of emotions. Emotions are an immediate response by the organism informing it of the degree of favorability of a certain stimulus or situation. Moods are similar to emotions but more intense and prolonged. Some studies indicate that the consumption of hyperpalatable energy-dense foods may be related to emotional eating. Emotional eating is characterized by the excessive consumption of hyperpalatable energy-dense foods, rich in sugars and fats, in response to negative emotions. But several reports also indicate that emotional eating may be associated with the presence of positive emotions, so further analysis of the available information is necessary. Consuming higher amounts of hyperpalatable energy-dense foods can lead to the accumulation of energy in the body that results in an increase in body weight, as well as other associated diseases. Obesity is the world's leading diet-related health problem. The objective of this work was to carry out a systematic review of the available literature using the Cochrane methodology, in accordance with the PRISMA guidelines, to evaluate the relationship between emotional eating, the consumption of hyperpalatable energy-dense foods, and indicators of nutritional status. An exhaustive search in different databases yielded 9431 scientific articles, 45 of which met the inclusion criteria. This review underscores the fact that knowing and understanding the reasons why people consume hyperpalatable energy-dense foods and the possible connection with their emotional eating can provide key data for improving and personalizing patients' nutritional treatment. This in turn can encourage compliance with treatment plans to improve people's health and quality of life using an interdisciplinary approach.

The Relationship between Adults' Perceptions, Attitudes of COVID-19, Intuitive Eating, and Mindful Eating Behaviors

In total, 1224 Turkish adults (27.5 ± 9.6 years; 80.6% female) answered sociodemographic questions, and three instruments: Mindful Eating Questionnaire (MEQ), Intuitive Eating Scale-2 (IES-2), and COVID-19 Perception and Attitude Scale. Women's perceptions and attitudes toward COVID-19 indicated higher concerns than men (p < .001). It was found that IES-2 scores of all subjects increased as body mass index (BMI) decreased and education level increased (p < .001; p = .033, respectively). During the social isolation of COVID-19, the MEQ scores of married couples and those who did not eat take-out foods were higher (p = .027; p = .006, respectively). Interestingly, it was found that as the BMI of the subjects increased, their MEQ scores increased (p < .001). The COVID-19 pandemic, which has social and economic consequences, has a great impact on human health and causes sudden lifestyle changes through social distance and isolation at home. Although social isolation during the epidemic is a necessary precaution to protect public health, the results of this study support that it causes changes in intuitive eating, and mindful eating behaviors.

Differing Experiences of Boredom During the Pandemic and Associations With Dietary Behaviors

OBJECTIVE

To examine how changes in feeling bored and eating because of boredom during the coronavirus disease 2019 (COVID-19) pandemic relate to intuitive eating, diet quality, and snacking.

METHODS

A representative sample of 360 US adults completed an online survey including changes in feeling bored and eating because of boredom since the COVID-19 pandemic. An ANCOVA and multivariate analysis of covariance were used to examine relationships between intuitive eating, diet quality, and snacking in individuals who experienced: (1) increases in feeling bored and eating because of boredom, (2) eating because of boredom only, (3) increases in feeling bored only, and (4) no change/decreases in feeling bored and eating because of boredom.

RESULTS

Individuals who increased feeling bored and eating because of boredom and increased eating because of boredom only snacked more and scored lower in intuitive eating. Diet quality did not differ across groups.

CONCLUSIONS AND IMPLICATIONS

Although diet quality did not differ, eating because of boredom is potentially a negative impact on diet quality. Programs enhancing intuitive eating may be helpful.

Adolescents Emotional State and Behavioral and Dietary Habit Changes during Isolation Due to the COVID-19 Pandemic

INTRODUCTION

The coronavirus disease 2019 (COVID-19) was recognized as a pandemic by the World Health Organization on March 11, 2020. As an infectious disease with no specific treatment, several measures have been established to minimize the outbreak of this disease, including social isolation.

OBJECTIVE

To evaluate the behavior of adolescents during the isolation period.

METHODS

This is a cross-sectional descriptive study conducted at the Adolescent Health Studies Center. Data were obtained from a questionnaire prepared on Google Forms, sent by a multiplatform instant messaging application, and analyzed using the Stata 14 software.

RESULTS

A total of 208 adolescents with a mean age of 15.3 years (SD ± 1.8) answered the questionnaire, 57.7% were female. About 93.3% of adolescents said they were in isolation with a changed routine, 67.3% increased their food consumption, 86.5% were inactive, and 58.7% reported screen time over 8 h/d. There was an association between anxiety and increased food consumption (odds ratio: 3.9; CI 95% 2-7.5; p = 0.00), sleeping difficulty (odds ratio: 3.6; CI 95% 1.9-6.8; p = 0.00), and conflicting family relationship (odds ratio: 5.7; CI 95% 1.6-7.8; p = 0.01).

CONCLUSION

The study revealed that social isolation due to an infectious disease was associated with several effects on the behavior and eating behavior of adolescents, which need to be acknowledged to encourage them to lead a healthy lifestyle after the COVID-19 confinement.

The Perceived Impact of COVID-19 on Comfort Food Consumption over Time: The Mediational Role of Emotional Distress

The COVID-19 pandemic has had a significant impact on populations at an economic, health, and on an interpersonal level, it is still unclear how it has affected health-risk behaviors, such as comfort food consumption over time. This study longitudinally examines the effect of the perceived impact of COVID-19 on comfort food consumption and whether this effect is mediated by emotional distress. A convenience sample of 1048 students and university staff (academic and non-academic) from two universities completed monthly online surveys during the COVID-19 pandemic across six waves (W; W1 to W6). Participants reported their perceived impact of COVID-19 (economic, interpersonal, and health), comfort food consumption, and emotional distress (DASS-21). Using structural equation models, we found an indirect longitudinal effect of the perceived impact of COVID-19 (W1) on comfort food consumption (W3 to W6) through increased emotional distress (W2). The perceived negative impact of COVID-19 on comfort food consumption was fully mediated by the emotional distress during the first waves (W3 and W4), ending in a partial mediation in the last waves (W5 and W6). These findings contribute to disentangling the mechanisms by which the perceived impact of COVID-19 affects comfort food consumption over time, and highlight the role of emotional distress. Future interventions should address comfort food consumption by focusing on handling emotional distress during a crisis.

COVID-19 Perceived Impact and Psychological Variables as Predictors of Unhealthy Food and Alcohol Consumption Trajectories: The Role of Gender and Living with Children as Moderators

The present study examines the trajectories of unhealthy food and alcohol consumption over time and considers whether perceived impact of COVID-19 and psychological variables are predictors of these trajectories. We ascertained whether these predictors are different in women vs. men and between women living with vs. without children. Data were collected through online surveys administered to 1038 participants from two universities (staff and students) in Chile, across five waves (July to October 2020). Participants provided information about their past-week unhealthy food and alcohol consumption and mental health. Using latent growth curve modeling analysis, we found that higher perceived health and interpersonal COVID-19 impact, younger age and lower depression symptoms were associated with more rapid increases over time in unhealthy food consumption. On the other hand, higher perceived COVID-19 economic impact and older age were associated with more rapid diachronic decreases in alcohol consumption. Gender and living with or without children, for women only, were moderators of these trajectories. This longitudinal study provides strong evidence identifying the multiple repercussions of COVID-19 and mental health factors on unhealthy food and alcohol consumption. These findings highlight the need for interventions aimed at minimizing the impact of the pandemic on unhealthy food and alcohol consumption over time.

Characterising binge eating over the course of a feasibility trial among individuals with binge eating disorder and bulimia nervosa

Binge eating disorder and bulimia nervosa are eating disorders that are characterized by recurrent binge eating episodes. The highly contextualized nature of binge eating makes naturalistic research a particularly suitable means of understanding the context within which binge eating occurs. The present study aimed to characterise binge eating days with regards to the frequency and probability of negative affect, food craving, meal skipping, and dietary restriction. In addition, it aimed to examine whether a combined intervention that targets the experience of 'loss of control' over eating can decrease these potential maintenance factors that often precede binge eating episodes. Seventy-eight participants with bulimia nervosa (N = 40) or binge eating disorder (n = 38), who were randomly allocated to a food-specific or general intervention combining inhibitory control training and implementation intentions, completed mood and food diaries over four weeks. Results suggest that negative affect and food craving were elevated on binge eating days, but that dietary restraint and meal skipping did not characterise binge eating days. Moreover, meal skipping, binge eating, restriction, and compensation decreased throughout the intervention period, while negative affect and food craving did not. This suggests that some interventions may successfully reduce binge eating frequency without necessarily decreasing negative affect or food craving, thus pointing to the different routes to targeting binge eating and providing implications for future interventions.

Influence of COVID-19 on lifestyle behaviors in the Middle East and North Africa Region: a survey of 5896 individuals

BACKGROUND

Coronavirus disease (COVID-19) pandemic has affected health and lifestyle behaviors of people globally. This project aims to identify the impact of COVID-19 on lifestyle behavior of individuals in the Middle East and North Africa (MENA) region during confinement.

METHODS

We conducted an online survey in 17 countries (Egypt, Jordan, United Arab Emirates, Kuwait, Bahrain, Saudi Arabia, Oman, Qatar, Yemen, Syria, Palestine, Algeria, Morocco, Libya, Tunisia, Iraq, and Sudan) from the MENA region on August and September 2020. The questionnaire included self-reported information on lifestyle behaviors, including physical activity, eating habits, smoking, watching television, social media use and sleep before and during the pandemic. Logistic regression was performed to analyze the impact of COVID-19 on lifestyle behaviors.

RESULTS

A total of 5896 participants were included in the final analysis and 62.8% were females. The BMI of the participants was 25.4 ± 5.8 kg/m2. Around 38.4% of the participants stopped practicing any physical activities during the confinement (P < 0.001), and 57.1% reported spending more than 2 h on social media (P < 0.001). There were no significant changes in smoking habits. Also, 30.9% reported an improvement in their eating habits compared with 24.8% reported worsening of their eating habits. Fast-food consumption decreased significantly in 48.8% of the study population. This direct/indirect exposure to COVID-19 was associated with an increased consumption of carbohydrates (OR = 1.09; 95% CI = 1.02-1.17; P = 0.01), egg (OR = 1.08; 95% CI = 1.02-1.16; P = 0.01), sugar (OR = 1.09; 95% CI = 1.02-1.16; P = 0.02), meat, and poultry (OR = 1.13; 95% CI = 1.06-1.20; P < 0.01). There was also associated increase in hours spent on watching television (OR = 1.07; 95% CI = 1.02-1.12; P < 0.01) and social media (OR = 1.09; 95% CI = 1.01-1.18; P = 0.03). However, our results showed a reduction in sleeping hours among those exposed to COVID-19 infection (OR = 0.85; 95% CI = 0.77-0.94; P < 0.01).

CONCLUSIONS

The COVID-19 pandemic was associated with an increase in food consumption and sedentary life. Being exposed to COVID-19 by direct infection or through an infected household is a significant predictor of amplifying these changes. Public health interventions are needed to address healthy lifestyle behaviors during and after the COVID-19 pandemic.

Emotion Regulation Difficulties Strengthen Relationships Between Perceived Parental Feeding Practices and Emotional Eating: Findings from a Cross-Sectional Study

BACKGROUND

People with emotional eating (EE) may experience weight gain and obesity, eating disorder psychopathology, and emotion dysregulation. Limited research has examined experiences in childhood that may be associated with EE in adulthood. Perceived parental feeding practices and emotion regulation difficulties were examined as correlates of negative and positive EE in adulthood.

METHODS

A cross-sectional study using an online community sample of adults (N = 258) examined self-reported negative (Emotional Eating Scale-Revised; EE-anger/anxiety, EE-boredom, and EE-depression) and positive (Emotion Appetite Questionnaire; EE-positive) EE, perceived parental feeding practices (Child Feeding Questionnaire), and emotion regulation difficulties (Difficulties in Emotion Regulation Scale).

RESULTS

Moderation analyses calculated in PROCESS macro examined emotion regulation difficulties as a moderator of relationships between perceived parental feeding practices and EE. Across all models tested, age, BMI, and gender were entered as covariates. Higher perceptions of parental control (monitoring and restriction) of unhealthy eating behaviors and pressure to eat were more strongly associated with EE-anger/anxiety and EE-positive when emotion regulation difficulties were high. Higher perceptions of parental restriction of unhealthy eating behaviors and pressure to eat were more strongly associated with higher EE-boredom when emotion regulation difficulties were high. No significant interactions between perceived parental feeding practices and emotion regulation difficulties emerged in relation to EE-depression.

CONCLUSIONS

Perceived controlling parental feeding practices and emotion regulation difficulties may explain meaningful variance in negative and positive EE in adulthood.

What is boredom proneness? A comparison of three characterizations

OBJECTIVE

Boredom proneness is associated with various problematic behaviors and mental health issues. Despite its wide-ranging implication, boredom proneness as a trait-like construct suffers from conceptual ambiguity and measurement issues. We examined whether boredom proneness represents individual differences in (a) the frequency of getting bored, (b) the intensity of boredom, and/or (c) a holistic perception of life being boring (perceived life boredom).

METHOD

Across Study 1 (U.S. Sample, N = 495; HK Sample, N = 231) and Study 2 (N = 608), we tested the construct validity of boredom proneness by estimating its association with measures of the three possible characterizations (convergent validity), and examined to what extent associations between boredom proneness and variables relevant to well-being (e.g., life satisfaction, psychological distress) could be reproduced with the three potential characterizations (concurrent validity).

RESULTS

Results suggest that each of the three characterizations represents some aspect of boredom proneness, and they generally reproduced boredom proneness' associations with other variables. Among them, perceived life boredom had the strongest convergent and concurrent validity.

CONCLUSION

Our findings provide novel insights into the characterization of boredom proneness and its hitherto poorly understood relationship with psychological well-being.

Emotional Regulation and Overeating Behaviors in Children and Adolescents: A Systematic Review

The worldwide prevalence of obesity has dramatically increased, mostly in children and adolescents. The Emotional Eating theoretical model has proposed that the failure in emotional regulation could represent a risk factor for establishing maladaptive overeating behavior that represents an inadequate response to negative emotions and allows increasing body-weight. This systematic review investigates the relationship between overeating and both emotional regulation and emotional intelligence in childhood and adolescence, considering both cross-sectional and longitudinal studies. Moreover, another goal of the review is evaluating whether emotional regulation and emotional intelligence can cause overeating behaviors. The systematic search was conducted according to the PRISMA-statement in the databases Medline, PsychArtcles, PsychInfo, PubMed, Scopus, and Web of Sciences, and allows 484 records to be extracted. Twenty-six studies were selected according to inclusion (e.g., studies focused on children and adolescents without clinical conditions; groups of participants overweight or with obesity) and exclusion (e.g., studies that adopted qualitative assessment or cognitive-affective tasks to measure emotional variables; reviews, commentary, or brief reports) criteria detailed in the methods. Cross-sectional studies showed a negative association between emotional regulation and overeating behavior that was confirmed by longitudinal studies. These findings highlighted the role of maladaptive emotion regulation on overeating and being overweight. The relationship between these constructs in children and adolescents was consistent. The results indicated the complexity of this association, which would be influenced by many physiological, psychological, and social factors. These findings underline the need for further studies focused on emotion regulation in the development of overeating. They should analyze the mediation role of other variables (e.g., attachment style, peer pressure) and identify interventions to prevent and reduce worldwide overweight prevalence.

Application of three different coaching strategies through a virtual coach for people with emotional eating: a vignette study

BACKGROUND

Around 13% of the world's population suffers from obesity. More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). It is an alternate to more effective coping strategies for negative emotions. Our study explored the opportunities for helping adults with emotional overeating using a virtual coach, aiming to identify preferences for tailored coaching strategies applicable in a personal virtual coach environment. Three different coaching strategies were tested: a validating, a focus-on-change, and a dialectical one - the latter being a synthesis of the first two strategies.

METHODS

A qualitative study used vignettes reflecting the two most relevant situations for people with emotional eating: 1. experiencing negative emotions, with ensuing food cravings; and 2. after losing control to emotional eating, with ensuing feelings of low self-esteem. Applied design: 2 situations × 3 coaching strategies.

PARTICIPANTS

71 adult women (Mage 44.4/years, range 19-70, SD = 12.86) with high scores on the DEBQ-emotional eating scale (Memo 3.65, range 1.69-4.92, SD = .69) with mean BMI 30.1 (range 18-46, SD = 6.53). They were recruited via dieticians' practices, were randomly assigned to the conditions and asked how they would face and react to the presented coaching strategies. Data were transcribed and a thematic analysis was conducted.

RESULTS

Qualitative results showed that participants valued both the validating coaching strategy and the focus-on-change strategy, but indicated that a combination of validation and focus-on-change provides both mental support and practical advice. Data showed that participants differed in their level of awareness of the role that emotions play in their overeating and the need for emotion-regulation skills.

CONCLUSION

The design of the virtual coach should be based on dialectical coaching strategies as preferred by participants with emotional eating behaviour. It should be tailored to the different stages of awareness of their emotions and individual emotion-regulation skills.